What treatments can help cervical spinal stenosis?
Ask the doctor
Q. I have neck pain due to cervical spinal stenosis. Is surgery recommended as the first treatment option, or is there an alternative (such as medication) to relieve pain and correct the condition?
A. Cervical spinal stenosis means narrowing of the space around the nerves and spinal cord in the neck. Because there isn't much extra space near the spinal cord in the neck, any condition that narrows this space can cause significant problems.
Cervical spinal stenosis occurs most commonly because of arthritis, disc bulging or age-related degeneration, calcium deposits in the spinal ligaments, a fracture, or a combination of these conditions. Some people are born with a cervical spinal canal that is more narrow, increasing the chances of related symptoms with advancing age.
Typical symptoms of cervical spinal stenosis include neck pain, limited neck motion, extremity weakness or numbness, and balance problems. In more severe cases, bowel or bladder problems may develop.
A related condition, nerve root compression, may cause similar symptoms, and it can develop for the same reasons. Nerves enter and exit the spinal cord through small openings between the bones of the spine; it doesn't take much arthritis, disc slippage, or other spine disease to compress these nerves.
In most cases, surgery is not an initial treatment for this condition. Nonsurgical options that are more commonly recommended as initial treatment include:
- heat, cold, stretching exercises, massage, and acupuncture
- a neck brace or soft collar
- pain relievers or anti-inflammatory medicines
- muscle relaxants
- antiseizure medicines
- steroids
- nerve-deadening injections (called nerve blocks)
Surgery is usually a last resort. A surgeon removes disc material or bone to allow more room for the spinal cord and nerves within the neck.
Talk to your doctor about these treatment options, and other possible causes of neck pain such as nerve root compression, muscle spasm, or arthritis.
Image: © gorodenkoff/Getty Images
About the Author
Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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